ABSTRACT The principal objective of the Hawaii IDeA Center for Pediatric and Adolescent Clinical Trials (HIPACT) is to establish a pediatric clinical trials team in Hawaii to participate in community valued, and scientifically valid multi-center clinical trials, as a partner in the IDeA States Pediatric Clinical Trials Network (ISPCTN). The overarching goal is to improve the health and wellbeing of the diverse multiethnic populations of Hawaii. As the western most IDeA-eligible state, Hawaii is home to large populations of diverse rural and underserved populations, including indigenous Hawaiian communities, and immigrant populations of Pacific Islanders and Asians. These communities suffer geographic isolation nationally as well as locally resulting in significant health inequities. Few clinical trials have targeted children from these ethnic groups or Islands. This is unfortunate because these same communities offer a stable population base that is ideal for conducting long- term longitudinal studies. The community-based University of Hawaii at Manoa (UH Manoa) John A. Burns School of Medicine (JABSOM) Department of Pediatrics (DOP) will serve as the home for HIPACT with an innovative fusion of local and national entities included as partners. Locally, our first partner is the Hawaii Pacific Health (HPH) owned regional perinatal medical center - Kapiolani Medical Center for Women and Children (KMCWC) and the HPH Research Institute (HPHRI). The second partner is the largest community health center in the state ? the Waianae Coast Comprehensive Health Center (WCCHC) that largely serves Native Hawaiians and Other Pacific Islanders. Nationally, partnerships have been established with the Mountain West IDeA Clinical and Translational Research-Infrastructure Network (CTR-IN), and the Research Centers in Minority Institutions Translational Research Network (RTRN). The following HIPACT Specific Aims are proposed: 1) To launch and implement pediatric clinical trials as an ISPCTN site by providing an experienced, coordinated, and a committed team of pediatric-trained personnel; 2) To engage Hawaii and other IDeA state communities to provide access to clinical trials including rural and underserved infants, children and adolescents, many of who are Asian, Native Hawaiians and Other Pacific Islanders; 3) To contribute to the ?science? of ISPCTN multicenter clinical trials research in disparate underserved and/or rural communities by better understanding and overcoming barriers, with the ultimate goal of improving health outcomes; and 4) To increase the number and expertise of JABSOM pediatric clinical trials faculty and their support teams through professional training and education, ultimately to expand ISPCTN research capacity. Hence, HIPACT is well positioned with a unique blend of rural and underserved communities, experienced leadership, committed partners and community leaders to work with ISPCTN and successfully launch and enroll infants, children and adolescents from Hawaii and across IDeA partner institutions in ISPCTN approved trials.